de la Torre, Manuel A.;
Buades‐Mateu, Juan;
de la Rosa, Pedro A.;
Lué, Alberto;
Bustamante, Francisco J.;
Serrano, María T.;
Testillano, Milagros;
Lorente, Sara;
Arenas, Juan I.;
Gil, Cristina;
Iñarrairaegui, Mercedes;
Sangro, Bruno
A comparison of survival in patients with hepatocellular carcinoma and portal vein invasion treated by radioembolization or sorafenib
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Medientyp:
E-Artikel
Titel:
A comparison of survival in patients with hepatocellular carcinoma and portal vein invasion treated by radioembolization or sorafenib
Beteiligte:
de la Torre, Manuel A.;
Buades‐Mateu, Juan;
de la Rosa, Pedro A.;
Lué, Alberto;
Bustamante, Francisco J.;
Serrano, María T.;
Testillano, Milagros;
Lorente, Sara;
Arenas, Juan I.;
Gil, Cristina;
Iñarrairaegui, Mercedes;
Sangro, Bruno
Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background & Aims</jats:title><jats:p>Sorafenib (<jats:styled-content style="fixed-case">SOR</jats:styled-content>) is the standard of care for patients with hepatocellular carcinoma (<jats:styled-content style="fixed-case">HCC</jats:styled-content>) and portal vein invasion (<jats:styled-content style="fixed-case">PVI</jats:styled-content>), based on the results of phase 3 trials. However, radioembolization (<jats:styled-content style="fixed-case">RE</jats:styled-content>) using yttrium‐90 microspheres has been shown to achieve higher response rates and better survival in large cohorts and phase 2 trials. This study aimed to compare survival of <jats:styled-content style="fixed-case">HCC</jats:styled-content> patients with <jats:styled-content style="fixed-case">PVI</jats:styled-content> treated by <jats:styled-content style="fixed-case">RE</jats:styled-content> or <jats:styled-content style="fixed-case">SOR</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Survival among patients with <jats:styled-content style="fixed-case">HCC</jats:styled-content> and <jats:styled-content style="fixed-case">PVI</jats:styled-content> treated with <jats:styled-content style="fixed-case">RE</jats:styled-content> or <jats:styled-content style="fixed-case">SOR</jats:styled-content> in four Spanish hospitals between 2005 and 2013 was analysed retrospectively. Kaplan–Meier survival curves were plotted and baseline variables tested for prognostic value using the log‐rank test. A multivariate prognostic model including variables identified in the univariate analysis and adjusted by a propensity score based on factors that may determine the probability of exposure to <jats:styled-content style="fixed-case">RE</jats:styled-content> was generated using Cox regression analyses.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>After a median follow‐up of 6 months, 60 deaths had occurred: 38 and 22 in <jats:styled-content style="fixed-case">SOR</jats:styled-content> and <jats:styled-content style="fixed-case">RE</jats:styled-content> groups respectively. Median survival was 6.7 months (95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 5.2–8.1 months) for the entire cohort, and 8.8 months (95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 1.8–15.8) in the <jats:styled-content style="fixed-case">RE</jats:styled-content> group and 5.4 months (95%<jats:styled-content style="fixed-case">CI</jats:styled-content> 2.7–8.1) in the <jats:styled-content style="fixed-case">SOR</jats:styled-content> group (<jats:italic>P</jats:italic> = 0.047). The difference in survival was still statistically significant when 13 patients in the <jats:styled-content style="fixed-case">RE</jats:styled-content> group who started <jats:styled-content style="fixed-case">SOR</jats:styled-content> after a median time of 8 months were censored from the analysis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In a cohort of patients with <jats:styled-content style="fixed-case">HCC</jats:styled-content> and <jats:styled-content style="fixed-case">PVI</jats:styled-content> treatment with <jats:styled-content style="fixed-case">RE</jats:styled-content> was associated with a more prolonged survival compared with <jats:styled-content style="fixed-case">SOR</jats:styled-content>.</jats:p></jats:sec>